Heart attack risk soars after an angry outburst

Angry outbursts increase stroke risk four-fold

In the two hours following an angry outburst, an individual's risk of suffering a heart attack increases by nearly five-fold, according to a new review of studies published in the European Heart Journal.

For the review, Harvard researchers analyzed nine studies conducted from 1996 to 2013 covering more than 4,500 heart attacks, 800 strokes, 450 cases of acute coronary syndrome, and 300 cases of heart rhythm problems.

Researchers found that in the two hours following an angry eruption, an individual's risk of suffering from a heart attack or an acute coronary syndrome increased nearly five-fold and the risk of suffering a stroke increased nearly four-fold. The risk of suffering from a dangerous heart rhythm disorder—ventricular arrhythmia—also increased in the hours after an angry eruption.

"Although the risk of experiencing an acute [heart] event with any single outburst of anger is relatively low, the risk can accumulate for people with frequent episodes of anger," says lead author Elizabeth Mostofsky, adding that this is "particularly important for people who have higher risk due to other underlying risk factors or those who have already had a heart attack, stroke or diabetes."

Among those patients with low risk factors who experience an angry outburst once a month, the bouts of anger could result in one additional heart attack per 10,000 people each year, researchers say. Among those with high risk factors, an angry outburst could lead to four extra heart attacks per year.

Among low-risk patients who experience five emotional outbursts each day, the bouts would cause an extra 158 heart attacks per 10,000 people each year. And among high-risk patients who are angry five times a day, the bout would cause an extra 657 heart attacks per 10,000 people each year.

Cardiologists weigh in on study

"Cardiologists have long known about the adverse effects of depression after a heart attack, but this article emphasizes the need to not only screen for depression but also screen for other components of mental stress," says Sripal Bangalore, a cardiologist at NYU Langone Medical Center.

Heart attacks leave behind a 'cellular trace

Moreover, "In managing a patient with [heart] disease, it is important to ascertain if the patient is quick to react when it comes to the anger response, as this personality trait may increase the risk of heart attacks and be worth treating," says Lenox Hill Hospital cardiologist Suzanne Steinbaum (Preidt, HealthDay, 3/3).


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